How to handle lazy LPN's on the team
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We do team nursing on our floor with an aide, LPN, and RN as the team leader for up to 10 patients. I'm new to this. We have a few LPN's who will ignore call lights and ask other people to take care...
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I have found that there are only 3 things to be done, and you kind of need them to be done in order. One, work your a$$ off. Let it be seen that you yourself are not lazy. Two, communicate with the offenders what you expect and don't do it in the form of a question or a choice. Just say it. "I expect you to have your patient cleaned up before you go on another smoke break." Or, "I need to get out of here on time, make sure you can go on time as well." Three, if behavior doesn't improve, document objectively with real numbers and events, and pass it up the chain. Repeat as necessary. If offender questions you about the documentation, respond with "yes, and you were aware it was a problem because I spoke to you about it prior to writing anything down."

I don't know any other way to do things. People will be the way they want to be, and some folks just don't want to work.

In LTC, we LPNs *do*assess each and every shift. It is silly to pretend otherwise. Sometimes I work with no RN and am the only nurse. So OF COURSE I assess. People try to come up with absurd word games like "data gathering" but it is the SAME thing.

Of course LPN's assess but legally, only the RN can make the claim. I always hated that as well when I was a LPN. You do all of the foot work and the RN takes a peak and calls whatever shots. Unfortunately, it's all about the legalities.

I have found that there are only 3 things to be done, and you kind of need them to be done in order. One, work your a$$ off. Let it be seen that you yourself are not lazy. Two, communicate with the offenders what you expect and don't do it in the form of a question or a choice. Just say it. "I expect you to have your patient cleaned up before you go on another smoke break." Or, "I need to get out of here on time, make sure you can go on time as well." Three, if behavior doesn't improve, document objectively with real numbers and events, and pass it up the chain. Repeat as necessary. If offender questions you about the documentation, respond with "yes, and you were aware it was a problem because I spoke to you about it prior to writing anything down."

I don't know any other way to do things. People will be the way they want to be, and some folks just don't want to work.

I am the charge nurse responsible for a busy unit with a team model and I encounter this on almost a daily basis, as do many of the other RNs in charge. It really disgusts me how SOME of the LPN staff members can be so lazy and be grudge me because I have a pile of paper work and things to coordinate or otherwise over see in the nurses station, while still finding time to help many patients on the floor. These LPNs can't appreciate the level of stress and responsibility that goes onto the charge nurse, particularly after hours when we are the go to person for policy questions and issues. I would love for one day see these staff members just try and run the unit; they would crash and burn and panic in any emergency where they had to make decisions.

Why are you assuming that other nurses would "crash and burn?" Charge roles are extremely busy, but many people are well suited for these roles, including *gasp* some LPN's. Perhaps some of these people might even be more suited for a charge role than you think.

You have gotten wonderful advice. The only thing I want to add is to remember that RNS don't own LPNS or anyone else of that matter. Doctors don't go around saying "my RN". When I hear people use the term "my" when referring to others I get offended. I'm a RN that have been a CNA and LPN. That term used to get under my skin.

I have to admit that I don't really get this. Yes, I refer to the CNAs I work with as "my" CNAs. I also say "my" boss, "my" patient, etc. Doesn't everybody say "my" when referring to other people they're connected to? I'm sure you say "my boss" all the time. The CNAs sometimes say I'm "their" nurse. None of this means literal possession. Maybe you're too sensitive?......

1. check your own attitude/ego at the door
2. if it is truly teamwork how about saying - "Hey, let's work together and get this done so we can all sit down and catch our breath"
3. find out what's going on with the LPN by asking her. It could totally be something else going on that explains her frequent breaks - maybe a bad back, maybe a diuretic. Maybe she really is just lazy. I would definitely try to find out what's up with her before going to the supervisor.
4. having said all that, it's been 21 years since I've been in the hospital setting. But, I've worked in management for a number of years and found that it is always best when the one in charge leads by example. I am no expert, but I do try.
5. One other thing I try to do is to let employees try to solve the issue before getting involved. Suck it up and ask the LPN what's up.

Just to answer this question and this question only,...Honestly, I would have to say you have to have a respect and rapport with your co-workers. Sometimes this this makes for a better work environment and sometimes it does not. Even if you respect them, they may not respect you. There are numerous "reasons" for this, IMO. It could be they were there before you and therefore think they should set the rules, regardless of your title. Sometimes they just do it their way and are stubborn and resist changing what is easier for them. Sometimes, even the best charge nurses or RN team leaders cannot change a bad work environment if they do not have the backing and support of their higher ups.

This is always a tough part of being in a leadership position, of any kind. I found what works best for me is to 1) Respect the people I work with. 2) Earn their respect in return.

What does this mean in real terms? Simply put, do unto others as you would have them do unto you. For example, I used to work with an RN who would walk all the way down the hallway to "delegate" (tell) the CNA to empty her patient's urinal, then walk back down the hallway to finish whatever she was doing. Of course, the CNA's hated this, not only was it completely inefficient, but it gave the image that they were only there to deal with bedpans and urinals. They did not feel respected or appreciated, and it certainly impacted their willingness to help in future situations. While it is certainly within the RN's job to delegate, it must be done judiciously, with respect and good sense. I found that by doing what I could for myself, I earned a reputation as a hard worker, and built loyal, trusting relationships with the various team members. They know that if I ask for help, they better come running, because I need it. Now they offer help when I don't expect it, again building on mutual respect. And I use that for leverage. On the rare occasion that someone is not being a team player, I say "You know me. If I didn't need you to do this for me, I wouldn't ask. Please help me, and I'll be sure to return the favor. Thanks."

Another thing that goes a long way is praise - people absolutely need positive reinforcement to feel respected and appreciated, and this cannot be said enough. I worked with a nurse that was great clinically but mean to everyone on staff - no one escaped going home in tears at least once because of her. Then one day she was behind the curtain. I didn't know it, and praised her to my patient, saying she was the absolute best at starting IV's. From that day forward she was never rude to me again. I guess people rarely praised her because she had such a gruff countenance, but wow, what a difference a little praise made! I think the sincerity made a difference too. People can smell horse manure a mile away, so make sure when you give praise, you mean it.

this could be approached in a staff meeting in a general sense. Maybe everyone needs to consider work loads and expectations, etc. Then, once that is out in the open, if anyone is not fulfilling expectations the manager needs to be told.

Funny, I have been in this situation with one of my "teams" in the past, as a Supervisor. Thinking of your reply, I know if I had brought this up in a team meeting, it would have gotten nowhere. I had private meetings with the DON, and it went nowhere. My higher ups were not supportive. There didn't seem to be any answers. Sometimes it is like that. Sometimes, later, as team members come and go, things straighten out for that institution/unit/facility, but it may not be for a long time...and a person might have to stick it out... the only other choice is to leave.